STANDARDS FOR EXCELLENCE

RECERTIFICATION

STANDARDS FOR EXCELLENCE

Recertification Self-Study Application Package & Checklist

© 2012Pennsylvania Association of Nonprofit Organizations (PANO)

The recertification Self-Study Application Package and Checklist for the Standards for Excellence® Voluntary Certification Program consists of this form and attachments that the organization will supply and label according to these instructions. PANO may request additional documentation or information for clarification purposes. Please read the Standards for Excellence and this Self-Study Application Package thoroughly before beginning the application process. For questions and concerns, please call PANO staff at 717-236-8584 Ext. 1001 or Ext. 1011.

Please complete this application and return it with full payment (see fee schedule).

Pennsylvania Association of Nonprofit Organizations (PANO)

777 East Park Drive, Suite 300

Harrisburg, PA 17111

Date of Application:

Name of organization:

Is the organization known by other names or acronyms?

Address:

Phone:Fax:Website address:

Name of contact person if other than CEO/Chief Officer:

Title:

Phone:Email:

Number of paid staff (please provide the approximate number of full time equivalents):

Number of volunteers (not including board members):

Number of board members (independent of staff):

Total expenditures (last fiscal year completed):

Organization's fiscal year runs from: to

Date of Incorporation:

Certification Statement:

We certify that the information provided in this Standards for Excellence Self-Study Application Package and Checklist is true and correct, policies outlined are followed and all licenses, permits, insurance and governmental approval necessary for operations have been obtained.

Chair of BoardCEO or Other

SignatureSignature

Print namePrint name

TitleTitle

PhonePhone

Welcome to the Standards for Excellence®Recertification process. The Pennsylvania Association of Nonprofit Organizations (PANO) encourages organizations to contact the association staff for assistance in implementing the policies and practices described in the Standards for Excellence: An Ethics and Accountability Code for the Nonprofit Sector®. Training programs and extensive written educational materials are available. Our intent is that every applicant will ultimately be successful in achieving compliance with the Standards for Excellence.

Self-Study Application Instructions

  1. Read the Standards for Excellence: An Ethics Code for the Nonprofit Sector.
  2. Read the Recertification Self-Study Application Package.
  3. Determine which attachments provided in your initial application remain unchanged to this date and which portions of your application have changed since your initial application. Assemble documents to update your application (the five binders in your possession).
  4. For items that remain unchanged since your initial application, leave the documents in the original application package.
  5. For attachments which have changed or which require updating, remove the original documents and add the new documents to your application package. Pay special attention to items identified as “expectations” by the peer review team during your initial application review.
  6. Send 1 copy of the completed and signed copy of this Recertification Self-Study Application and Checklist Package with updated and original unchanged information (see below for instruction for hard copy and electronic submission) along with the required fee to the Pennsylvania Association of Nonprofit Organizations. Contact PANO for a copy of the fee schedule that applies to your organization.
  7. Following the staff review (Phase 1) of the Self-Study Application, staff may request additional materials. Forward one set of materials to PANO and add materials to the other Self-Study Applications. Mail three copies to the PANO office for the Peer Review (Phase 2) review. (One copy of the application is kept with the organization.)

●We recommend that organizations interested in participating in this program appoint a Standards for Excellence committee or task force made up of board members and key staff to work together in assembling this comprehensive Self-Study Application. Please see the codes in parentheses following each question in the application for a reference to the relevant portion of the Standards for Excellence: An Ethics and Accountability Code for the Nonprofit Sector.

●Applicants are invited to use this Self-Study Application and the accompanying documents to illustrate the organization's implementation of the 55 Standards. If one or more of the Standards is not appropriate for the organization, please write "n/a" in the space provided on the Self-Study Application Package Checklist and provide a detailed explanation of the special circumstances that preclude the applicant from implementing the standard. In some cases, a special written waiver request will be required.

●Applicants may choose to submit their application in hard copy format or electronically in PDF on CDs. Please see below for instructions.

Electronic Submission

For the Phase I review, please provide one copy on a rewritable CD (CD RW) or flash drive. Please provide an index of the documents. Use folders to divide the application in eight sections corresponding to the Guiding Principles along with a ninth section for disclosure. Attachments should be coded with numbers provided in these instructions (i.e., I-a, I-b, I-c… etc.). Please ask for the copy of more detailed electronic submission directions.

● If the answers to a particular question can be found elsewhere in the application, create and label a separate document. Include a short sentence explaining where it is located on the CD or flash drive.

● If a particular Standard is not applicable to your organization, please explain why the Standard is not applicable and include this explanation in a separate labeled document.

●For questions which request a narrative answer, please keep responses to one page or less (with the exception of the program evaluation section that may require longer responses).

●To speed the Self-Study Application and peer review process, carefully check to be sure that all attachments are enclosed. See last page of Self-Study Application package for a complete list of requested attachments.

●Applicants should keep a copy of the completed application and accompanying materials for future reference.

●Upon completion of the Phase I review, submit three additional copies of the documentation.

Upon completion of the Phase I review, submit three additional copies.

Self-Study Application Review Process

Staff Review (Phase I)

Once a Self-Study Application Package is received by the Pennsylvania Association of Nonprofit Organizations, Standards staff will conduct an initial review of the materials. At that point, staff will contact the applicant organization via phone, letter and/or in-person consultation if additional information or clarification is needed.

Peer Review (Phase II)

Completed Self-Study Application Packages will be forwarded to a team of trained peer reviewers. The team will thoroughly review the Self-Study Application Package and make a recommendation to the Standards Committee. At this time, Standards staff may request an in-person consultation to discuss clarification or additional information needed as a result of the peer review team meeting. A site visit will take place to provide a clear sense of operations and services rendered.

A site visit will take place upon completion of the Peer Review.

Standards Committee Review

The Standards Committee makes the final decision regarding an organization's Self-Study Application. Applicants may request reconsideration by the Standards Committee if not satisfied with the initial decision. A formal appeal process is also available.

●Every effort will be made to avoid conflicts of interest in the peer review process. Peer reviewers will be required to disclose their interests and organizational involvement in a disclosure form. Applicants will be given the opportunity to identify peer reviewers who may have a conflict of interest.

●Staff, peer reviewers and Standards Committee members will adhere to a strict confidentiality policy that safeguards the confidentiality of all aspects of the Self-Study Application submitted and applicant organization. The identity of peer reviewers evaluating a specific Self-Study Application will remain anonymous to the public and applicant organizations.

Standards for Excellence® Program

●Materials submitted will not be subject to public inspection and will be viewed only by PANO Standards staff and individuals involved in the Peer Review process, unless permission is granted by the applicant organization to allow others to view documents.

●Only organizations that have successfully completed the Peer Review process will be publicly announced.

●The Standards for Excellence Seal® will be awarded for three years, based on licensing guidelines governing the seal. In the years between Certification and Recertification, Seal Holders may be required to respond to annual requests for updated information and documentation. Prior to the end of the third year, organizations wishing to maintain the Seal must take part in the Recertification process. Once recertified, the Seal is awarded for five years.

This Self-Study Application requests many different policies and written descriptions of organizational procedures and practices. Some policies requested must be approved by the board of directors. For board-approved policies, the date of board approval is generally requested. Other policies requested may be management or operational policies. For these policies, applicants should note that policies have been implemented or enacted in the organization and provide documentation.

1

STANDARDS FOR EXCELLENCE

RECERTIFICATION

I. Mission and Program

A. Mission

I-aAttach the organization’s written mission statement. (Standard IA1)

YES NO Has the organization’s mission statement changed since the initial application?

YES NOHas the organization’s board of directors reviewed the organization's mission statement since the initial application? If so when? / / (Standard IB1) Mission should be reviewed periodically (e.g., 3 to 5 years). Provide minutes, if available; otherwise, provide narrative explaining when and how this took place.

B. Organizational evaluation

I-bDescribe theorganization’s current activities; indicate how activities are consistent with the organization’s mission statement. (Standard IA1)

YES NO Have the organization’s activities changed since the initial application?

C. Program Evaluation

I-cAttach a list of the organization's current programs and indicate the percentage of total organizational effort that is expended on each program listed. (Organizational effort is defined by the organization itself based on any combination of time, funds and/or other resources.) (Standard IC1, IC2) Include a brief description of the methodology used for determining organizational efforts.

YES NO Have the organization’s programs changed since the initial application? Or, has thepercentage of total organizational effort that is expended on each program listed changed?

I-d______Describe how each of the organization’s programs are evaluated. For each program specifically address

  • What information is collected (qualitative and quantitative).
  • How outcomes are measured in relation to costs (programmatic efficiency).
  • How outcomes are evaluated for program participants (programmatic effectiveness).
  • Describe how the evaluation methods used

(1) involve program participants,

(2) are cost effective and/or

(3) appropriate forthe organization.

  • The board’s involvement in the evaluation process.
  • How your evaluation system is used to strengthen and improve the organization. In other words, describe the feedback loop your organization has in place for using evaluation to measure progress toward achieving your mission. If the organization does not serve individuals and/or families, describe how you treat constituents confidentially. (Standard IC1, IC2)

YES NO Have the organization’s program evaluation efforts changed since the initial application?

Please attach any evaluation tools (reports, questionnaires, templates) that provide further evidence of the organization's program evaluation efforts. (Please use discretion with the number of pages submitted.) (Standard IC1, IC2)

D. Program Service

I-eFor organizations serving individuals and/or families, attach a copy of the organization's policies regarding program participants and treatment of participants' confidential information. (Standard ID1)

YES NO Have the organization’s confidentiality policies for program participants changed since the initial application?

I-fDescribe how the organization measures the satisfaction of program participants. Include a description of how program participants are made aware of the grievance procedure. (Standard ID1)

YES NO Have the organization’s methods for measuring satisfaction of program participants changedsince the initial application?

I-gAttach a copy of the organization's grievance procedure to address complaints from program participants. (Standard ID1)

YES NO Have the organization’s grievance procedures changed since the initial application?

II. governing Body

  1. Board Responsibilities

II-aAttach copies of board minutes from the last 12 months. Please be sure that your submission of a year’s worth of minutes includes board minutes from a full fiscal year. You may need to provide board minutes for a period of time longer than a calendar year in order to include a full fiscal year. (Standard IIC6)

Indicate date and page of board minutes reflecting the following annual board responsibilities:

●Board's resolution indicating that the organization will apply for Recertification for PANO’s Seal of Excellence®. / / Page

●Board’s approval of the organization's most recent budget.//

Page (Standard IIA3)

●Board's most recent annual review of the percent of expenditures spent on program, administration and fundraising. (Many organizations conduct this review while discussing the organization's annual Form 990 or budget.) / / Page (Standard IIA3)

●Board’s approval of the organization’s most recent audit (if the organization has annual revenue in excess of $500,000). / / page_____.

●Board's most recent evaluation of the executive director.//

Page (Standard IIA4)

●Board's most recent approval of executive director's compensation package. _____/_____/_____

Page (Standard IIA4)

●Who is responsible for the board minutes? (Standard IIC5)

●Where are the board minutes kept? (Standard IIC5

II-bYES NOHas the board delegated decision-making authority to a committee in any specific subject areas? If so, what areas? Attach copies of committee minutes for committees which have been delegated decision making authority (executive, finance, audit, HR) by the board in areas that otherwise would be a board responsibility (for the last 12 months). (Standards IIA, IIC)

YES NOAre decisions made by committees with decision making authority reported to the full board? (Standard IIC6)

YES NOAre minutes distributed to board and committee members? (Standard IIC5)

II-cDescribe how the board of directors engages in long-term and short- term planning activities. If available, include copies of any documents illustrating board planning efforts (e.g., strategic plan for organization, board work plan, etc.). (Standard IIA1)

YES NO Has the board’s method of engaging in on-going planning activities changed since the initial application?

II-dAttach the organization's most recently approved budget. (Standard IIA3)

II-e YES NO Has the board hired an executive director in the last three years? If so, please describe the board’s process.

●Please indicate date (year) current executive director was hired. (Standard IIA4)

●Enclose a copy of the executive director’s contract (if one exists) and description of the executive director’s compensation package. If not indicated below in II-f, please provide a description of how the board has gathered data to determine comparability with fair market value for similar positions.

II-f______Describe the organization's compensation structure (i.e., assessing staff compensation) 1) Vertically – comparing the lowest paid to the highest paid, 2) horizontally – comparing similar positions in the organization and industry (for key positions, provide a description of how the board has gathered data to determine comparability with fair market value for similar positions) and 3) generally – relative to the economy.

If an organizational chart or other document may help illustrate your review, please attach.

YES NO Has the board reviewed the organization’s compensation structure in the last three years?

Pleaseprovide the date of the last review._____/_____/_____

If your board has not reviewed the salary structure in the last three years, when do you plan to do so? _____/_____/_____ (Standard IIA5)

Please Note: Personnel policies and financial policies covered in Standard IIA2 are requested in

Section IV (Human Resources) and Section V (Financial and Legal).

  1. Board Composition

II-g ______Attach a list of current board members with the following information for each member: name, principal employer, occupation, special skillsand the date each board member's term expires. Clearly mark the board officers and any employees who serve on the board. (Standard IIB1, IIB3 and IIB4)

YES NOAre any board members related by blood or marriage? If so, please explain.

(Standard IIB3)

YES NOAre any board members related to staff members by blood or marriage?

If so, please explain. (Standard IIB3)

II-hIf any employees serve as voting members of the board, please describe the circumstances that ensure that the employee(s) will not be in a position to exercise undue influence. (Standard IIB2)

II-iPlease provide an explanation of how your board reflects the diversity of the community served byaddressing the following:

(1) Define the community that the organization serves and address its diversity.

(2) Assess the board's diversity in relation to the community served. Applicants are asked to provide board composition in terms of gender and race. Applicants are also asked to provide board composition broken down by other social and/or demographic characteristics relevant to the organization such as occupation, age, geographic area, income status or program participant status.

(3) If your organization's board does not reflect the diversity of the community served, please describe the steps you are taking to achieve this diversity. (Standard IIB5)

II-jYES NO Do board members receive compensation for serving as board members (not including out of pocket expenses directly related to their board service)? If so, provide details of compensation arrangement. (Standard IIB6)

  1. Conduct Of The Board

II-k Describe the process utilized:

(1) Mechanisms used to assess board membership needs

(2) The recruitment process

(3) Sources utilized for potential board members.